This site needs JavaScript to work properly. Several features of these lesions favor their designation as hamartomas , including the lack of encapsulation; the mixture of acini, smooth muscles, adipose tissue, Paneth cells, and mucosal glands; and the lack of any cell atypia. General. Brunneroma with duodenojejunal intussusception: a rare cause of gastric outlet obstruction. Herein, we report the morphologic spectrum of hyperplastic changes culminating into dysplasia and carcinoma in 722 cases of BGH listed in our files. Brunner's gland hyperplasia is a rare elusive duodenal pathology, symptomatically mimicking alarming duodenal lesions and mostly diagnosed on histopathology of specimen. Sebaceous hyperplasia occurs when the sebaceous glands become enlarged with trapped sebum. The aim of this study is to evaluate the clinical presentations of patients with BG hyperplasia and hamartomas and to assess the pathological features of these lesions in association withHelicobacter pylori (H. pylori).Methods. Radiographic features of the duodenal mucosa were analyzed in a series of 26 patients in whom the diagnosis of Brunner gland hyperplasis (BGH) had been established by endoscopic biopsies. Please always ask your doctor for personalized diagnosis, evaluation, assessment, treatment and care management plan. The pathogenesis of Brunner’s gland hyperplasia remains unknown. Brunner's gland adenomas are uncommon benign duodenal tumors. Brunner’s Gland Hyperplasia and Hamartoma The nomenclature regarding Brunner’s gland lesions in the literature is not well es-tablished because there is a substantial de-gree of interchangeability among the terms “Brunner’s gland hyperplasia,” “Brunner’s gland hamartoma,” and “Brunner’s gland ad-enoma.” The proliferative lesions of the Brunner’s glands (BGs) are hyperplasia and hamartomas, and they are usually asymptomatic and very rarely diagnosed. A 67-year-old patient reported massive stenosis induced by Brunner’s gland hyperplasia of the second duodenal portion and canal dilation on an abdominal CT finding. The primary cause of Brunner’s gland hyperplasia was diagnosed in 1835 in an exceedingly patient with fatal duodenal intussusception. The small intestine constitutes 75% of the gastrointestinal tract; however, small … Our retrospective study included patients who underwent upper gastrointesti… Their main physiological function is to secrete an alkaline-based mucus to protect the duodenal lining from the acid secreted in the stomach. Brunner’s gland hyperplasia is clinically important because it can be mistaken for neoplastic lesions, although it is usually asymptomatic. Duodenal carcinoma originating in Brunner’s gland is rare. However, many studies have associated this condition with acid hypersecretion, chronic pancreatitis, uremia, and H. pylori infection. This is usually in such small amounts that it is not visible, but it can cause anemia and occasionally patients may pass or vomit blood. Herein, we report the morphologic spectrum of hyperplastic changes culminating into dysplasia and carcinoma in 722 cases of BGH listed in our files. Background . Brunner's gland adenoma (BGA) of the duodenum appear to be nodular hyperplasia of the normal Brunner's gland with an unusual admixture of normal tissues, … They are only found proximal to the sphincter of Oddi. Brunner’s gland hyperplasia is a rare cause of biliary obstruction and pancreatitis and the literature is limited to a few case reports [3, 4]. 2).  |  Making an accurate diagnosis of this polyp is usually easy based on AKA Brunneroma. @article{Janes2006BrunnersGH, title={Brunner's gland hyperplasia at the ampulla of Vater. These lobules extend from the submucosa into the lamina propria and within the mucosa alone and constitute atleast … The pathogenesis of Brunner's gland adenomas is unknown; it is thought to be the result of increased acid exposure resulting in hyperplasia of the Brunner's glands. They tend to be 1-2 cm in diameter, although case reports have described tumors of up to 12 cm diameter. Brunner’s gland hyperplasia is vary rare and Brunner’s gland hyperplasia is characterized by lobules of glands that are increased in both size and number, and are separated by thin fibrous septae. The pathogenesis of Brunner’s gland hyperplasia remains unknown. Cases of adenocarcinomas developed in Brunner gland hyperplasia (BGH) have been sporadically reported. © Copyright 2013, All Rights Reserved. Where the focal growth of hyperplastic cells is greater than 1 cm in diameter, the hyperplastic region is referred to as Brunner gland adenoma. A tentative diagnosis of duodenal polyposis was made. Their use or mentioning on this website is only for informational purposes. Although some reports describe rare cases of Brunner's gland adenocarcinoma, most of these cases do not unequivocably demonstrate de novo neoplasia within Brunner's glands, as opposed to secondary involvement of Brunner's glands by dysplasia or carcinoma arising in the surface mucosa. Bojanapu S, Mangla V, Mehrotra S, Lalwani S, Mehta N, Nundy S. J Surg Case Rep. 2018 Nov 30;2018(11):rjy305. The adrenal glands produce important hormones, including: 1. Brunneroma: A Rare Cause of Duodeno-duodenal Intussusception. Benign duodenal tumours are very rare with an estimated incidence of 0.008% reported in a series of 215 000 autopsies (1). Brunner’s Gland Hyperplasia and Hamartoma The nomenclature regarding Brunner’s gland lesions in the literature is not well es-tablished because there is a substantial de-gree of interchangeability among the terms “Brunner’s gland hyperplasia,” “Brunner’s gland hamartoma,” and “Brunner’s gland ad-enoma.” Brunner gland hyperplasia is an incidental finding in nearly 2% of gastroscopies . J Korean Med Sci. They are only found proximal to the sphincter of Oddi. Abbreviated BGH. Brunner's gland adenomas are uncommon benign duodenal tumors. Brunner's glands: the specialized areas of the inner lining of the DUODENUM , lying at the bottom of the CRYPT OF LIEBERKUHN . Congenital adrenal hyperplasia (CAH) refers to a group of genetic disorders that affect the adrenal glands, a pair of walnut-sized organs above the kidneys. Mayoral, W, Salcedo, JA, Montgomery, E & Al-Kawas, FH 2000, ' Biliary obstruction and pancreatitis caused by Brunner's gland hyperplasia of the ampulla of water: A case report and review of the literature ', Endoscopy, vol. Hyperplasia of Brunner's glands of the duodenum. Brunner’s gland hyperplasia is sometimes polypoid within the configuration. At operation, a cobblestone effect of the duodenal mucosa was found, and pathologic examination revealed the basic lesion to be a hyperplasia of Brunner's glands. However, in one case of Brunner’s gland hyperplasia, there’s a relationship involving the second duodenal portion of the duodenum with pancreatic invasion. Multiple lesions less than 5 mm are hyperplasia. Brunner’s gland hyperplasia is a rare, often benign proliferative disorder of the duodenum [1]. A case of the diffuse nodular variety of Brunner’s gland hyperplasia was reported once with symptoms of intermittent upper abdominal pain, nausea, and vomiting, which were difficult to differentiate from malignancy. | Designed and Developed by, Brunner’s gland Hyperplasia Symptoms, Causes, Cancer, Treatment. The underlying pathophysiological mechanism is unclear. Surgical polypectomy, wedge resection of the duodenum, or partial gastrectomy with extension to the duodenal bulb should then be performed. Cases of adenocarcinomas developed in Brunner gland hyperplasia (BGH) have been sporadically reported. Background. eCollection 2018 Nov. Patankar AM, Wadhwa AM, Bajaj A, Ingule A, Wagle P. Euroasian J Hepatogastroenterol. Brunner's gland hyperplasia: enlargement of duodenal glands. Large masses can cause symptoms of obstruction and compression, which can depend on the location of the tumor. Nodular proliferation of normal Brunner glands, ducts, stroma Also called Brunner gland hyperplasia or adenoma Usually in mid duodenum Associated with erosions and duodenitis May cause melena or obstruction Probably not neoplastic Brunner’s gland hyperplasia is usually asymptomatic, which means that it may show no symptoms or some symptoms such as abdominal pain, upper gastrointestinal bleeding, and may be associated with chronic pancreatitis. All cases in our series represented an incidentally discovered lesion. Herein, we report a case of duodenal carcinoma arising from Brunner’s gland in a 63-year-old man. It accounts for 10.6% of benign tumors in the duodenum and is often an incidental finding on endoscopy with the majority of patients being asymptomatic. Brunner’s gland hyperplasia is a rare elusive duodenal pathology, symptomatically mimicking alarming duodenal lesions and mostly diagnosed on histopathology of specimen. In 1934 Feyrter (3) classified hyperplasia of Brunner's glands into three types. Benign. Brunner’s gland hyperplasia is clinically important because it can be mistaken for neoplastic lesions, although it is usually asymptomatic. However, many studies have associated this condition with … : Hyperplasia of Brunner's glands is a rare phenomenon. doi: 10.1136/bcr-2012-008119. Duodeno-duodenal intussusception secondary to a Brunner's gland adenoma Endoscopic ultrasound can be useful in obtaining a correct diagnosis. Patients may harbour the lesion for long periods with little symptoms and upon treatment have good outcomes. The surgical treatment or hyperplasia of the Brunner's glands should be conservative since the lesion is not premalignant. Medical information provided on this website scrutinized to assure accuracy. Medical treatment serves to regulate gastric hyperacidity, which is one amongst the causes of Brunner’s gland hyperplasia. Brunner glands are compound tubular submucosal glands found in the duodenum. Brunner’s gland hyperplasia, a submucosal tumor, can be diagnosed by endoscopy, biopsy, abdominal CT, and other radiologic techniques. The AFIP uses the term Brunner's gland hamartoma for lesions > 5 mm. Only about 0.3-4.6% of the benign tumor originating from the duodenum can be found by the endoscope (6). Lee WC, et al. BMJ Case Rep. 2013 Mar 14;2013:bcr2012008119. Hyperplasia of Brunner’s glands probably represents a response of the duodenal mucosa to peptic ulcer disease. However, Brunner’s gland hyperplasia can result in severe symptoms, including gastrointestinal bleeding, abdominal pain, and ileus. Brunner’s gland polyposis is a rare diagnosis in an already unusual subset of duodenal tumours. Save my name, email, and website in this browser for the next time I comment. NLM Symptomatic hyperplasia of Brunner’s gland associated with pancreatitis is very rare, and the literature is limited to a few clinical cases. Brunner's gland hyperplasia has been attributed to multiple small polypoid or nodular lesions composed of excessive Brunner's glands separated by fibrous septa (Fig. The hyperplasia of Brunner’s glands and high accumulation of 68 Ga-DOTA-Exendin-4 in those Brunner’s glands resulting in a positive GLP-1R PET/CT scan (Figure 1(b)) is a surprising finding. Brunner’s gland was first described by Brunner in 1688. it’s a gland present within the mucosa and submucosa of the duodenum and performs the most physiological function of secreting alkaline mucus to shield the duodenal mucosa from acid secreted within the stomach. There are various other methods of resection of Brunner’s gland hyperplasia. These lesions are most often incidental findings at endoscopy but may bleed. The aetiology of these lesions is not yet clear. Clinical manifestations of Brunner’s gland hyperplasia are non-specific, like epigastric discomfort, bloating, dyspepsia, etc. Brunner’s gland hyperplasia is a rare elusive duodenal pathology, symptomatically mimicking alarming duodenal lesions and mostly diagnosed on histopathology of specimen. 2006 Mar 28;12(12):1966-8. doi: 10.3748/wjg.v12.i12.1966. Most cases of Brunner gland enlargement are probably hyperplasia because they maintain a normal lobular architecture, demonstrate little mitotic activity, and are histologically mature Brunner gland nodules may produce a mass lesion, but the histology is usually not adenomatous and can be readily distinguished from adenoma and adenocarcinoma Clipboard, Search History, and several other advanced features are temporarily unavailable. The difficulty of differentiating pathology, if the disease is not hereditary, is caused by the asymptomatic course of pathology. Can J Gastroenterol Hepatol. COVID-19 is an emerging, rapidly evolving situation. 2016 Jan-Jun;6(1):84-88. doi: 10.5005/jp-journals-10018-1174. It has been reported that their number increases in patients with cystic fibrosis, uraemia and Zollinger Ellison syndrome. Brunner's gland hyperplasia is a rare benign lesion of the duodenum and is usually found incidentally. Sporadic Non-ampullary Duodenal Adenoma Overriding the Cystic Dilatation of Brunner's Gland Hyperplasia. Androgens, such as testosterone, which are male sex hormones In people who have CAH, a genetic problem results in a l… They are an infrequent cause of upper gastrointestinal hemorrhage and duodenal obstruction but can occasionally mimic duodenal malignancy in their presentation. Rarely, a disorder known as hyperplasia can affect Brunner's glands. Hyperplasia of Brunner glands: The spectrum of its radiographic manifestations Dimitri Merine, Bronwyn Jones, Gary G. Ghahremani, Stanley R. Hamilton, Theodore M. Bayless School of Medicine Hyperplasia of the duodenal glands of Brunner was first described by pathologic anatomists in 1876 and introduced as a radiologic entity by Erb and Johnson (2) in 1948. tags: duodenum endoscopy Brunner's gland hyperplasia … Brunner’s gland hyperplasia is usually asymptomatic an… Brunner gland hyperplasia results from disproportionate overgrowth of Brunner glands in the duodenum as a result of hyperacidity.. Hyperplasia begins at the pylorus and extends distally within the first 2/3 rds of the duodenum. This image and the video clip have been observed with a magnifying endoscope. 2019 May 2;2019:6340565. doi: 10.1155/2019/6340565. Please enable it to take advantage of the complete set of features! Note: The AFIP uses the term Brunner's gland hamartoma for lesions > 5 mm. However, it does not substitutes a physician, hospital or medical care facility. Rocco A, Borriello P, Compare D, De Colibus P, Pica L, Iacono A, Nardone G. World J Gastroenterol. It is believed that the reason for Brunner’s gland hyperplasia is chronic inflammation, a chronic irritant because of excessive secretion of gastric acid, or a decrease in exocrine pancreatic function. Even though the frozen biopsy showed no signs of malignancy, they decided to continue the operation because they might not rule out the chance of malignancy. Brunner’s gland hyperplasia is a rare benign proliferative disease of the duodenum. Brunner gland hyperplasia (Brunner glands seen above the muscularis mucosae) Expansion of the lamina propria by mixed inflammatory cell infiltrate, including few neutrophils that usually do not infiltrate the epithelium Mildly increased intraepithelial lymphocytes, usually corresponding to Marsh 1 lesion (Mod Pathol 2005;18:1134) Brunner's gland hyperplasia: an unusual duodenal submucosal lesion seen in four patients. Epub 2016 Jul 9. The observed mucosal patterns could be classified into five categories: (1) focal BGH causing a solitary submucosal adenoma or a cluster of sessile polyps in the otherwise smooth duodenal bulb surface … Brunner’s gland hyperplasia is a benign lesion arising from the duodenum. Your email address will not be published. Related pathology Brunner gland hyperplasia Brunner gland adenoma Required fields are marked *. Conservative endoscopic or surgical resection followed by a regimen of antacids and H2 antagonists is the treatment of choice. It may cause obstructive symptoms, anemia or the patient may be totally asymptomatic. Gross. Brunner’s gland hyperplasia may be a very rare lesion of the duodenum that is usually asymptomatic and is diagnosed incidentally during upper gastrointestinal endoscopy. Brunner’s glands are duodenal glands localized predominantly in the submucosa of proximal duodenum. One of the key components of the diagnosis is foveolar metaplasia and it is disputed that this is really due to Helicobacter. Brunner's Gland Hyperplasias and Hamartomas in Association with. Brunner’s gland hyperplasia is a type of proliferative disease of the duodenum, which is a very rare case. Similar cystic changes can also be occasionally seen as a component of other Brunner’s gland lesions such as Brunner’s gland hyperplasia, hamartoma or adenoma. Patients with duodenal Brunner’s gland hyperplasia often suffer from chronic pancreatitis, peptic ulceration, and chronic erosive gastritis. Brunner’s gland hyperplasia is a rare benign proliferative disease of the duodenum. They are typically asymptomatic and picked up incidentally on endoscopy . Most often there are no symptoms, but sometimes abdominal pain occurs at night, or after meals, and there may also be bleeding from the gut. Radiology A barium study indicates that Brunner’s gland hyperplasia commonly appears as smooth, polypoid lesions of the duodenum and may show markedly thickened, irregular folds in the proximal duodenum because of concomitant duodenitis . Antral gland hyperplasia, brunner gland adenoma, heterotopic adenomatous polyp, GI disease A polypoid proliferation of antral glands with normal overlying foveolae, which occur in small clusters separated by bundles of smooth muscle Although complications are uncommon, a Brunner's gland tumor can … Brunner's gland hyperplasia at the ampulla of Vater. Brunner’s gland hyperplasia is asymptomatic or may present with abdominal pain, upper gastrointestinal bleeding and … 2008 Jun;23(3):540-543. https://doi.org/10.3346/jkms.2008.23.3.540 There is no consensus on the therapeutic principles of Brunner’s gland hyperplasia because follow-up research is insufficient since the disease is asymptomatic. Thus, removal is the preferred method. To reveal the tumor at the beginning of development is possible due to ultrasound, MRI or CT. Where the diameter of focal hyperplasia is less than 1 cm, the term Brunner gland hyperplasia is used.. Etiology remains obscure. Erb and Johnson speculated that the hyperplasia represented a possible protective mechanism against high gastric acidity. The aetiology of these lesions is not yet clear. We report a 16-year-old boy who presented with upper gastrointestinal haemorrhage from diffuse nodular hyperplasia of Brunner's gland without involvement of the first part of the duodenum. The diagnosis can be confirmed with endoscopic examination and upper gastrointestinal series. They are an infrequent cause of upper gastrointestinal hemorrhage and duodenal obstruction but can occasionally mimic duodenal malignancy in their presentation. Treatment of ongoing bleeding requires endoscopic or operative resection. This creates shiny bumps on the skin, especially … Brunner's glands are compound tubular submucosal glands found in that portion of the duodenum which is above the hepatopancreatic sphincter. Brunner's gland adenoma of duodenum: report of two cases. Brunner’s gland hyperplasia is a rare cause of biliary obstruction and pancreatitis and the literature is limited to a few case reports [3, 4]. There is considerable interchangeability between the terms hyperplasia, hamartoma, and adenoma. The difficulty of differentiating pathology, if the disease is not hereditary, is caused by the asymptomatic course of pathology. Although hyperplasia of Brunner's glands had been described by pathologic anatomists as early as 1876 (13), it was not until 1941 that a comprehensive survey of the pathologic processes common to these structures was published by Robertson (12). Brunner's gland hyperplasia has been attributed to multiple small polypoid or nodular lesions composed of excessive Brunner's glands separated by fibrous septa . }, author={S. Janes and A. Zaitoun and J. Catton and G. Aithal and I. Beckingham}, journal={Journal of postgraduate medicine}, year={2006}, volume={52 1}, … We study 52 people who have Brunner's gland hyperplasia. Brunner gland adenomas are hyperplastic areas of the Brunner glands within the duodenum that are greater than 1 cm. View chapter Purchase book Brunner's gland hyperplasia Brunner's gland hamartoma redirects here. Mineralocorticoids, such as aldosterone, which regulate sodium and potassium levels 3. tags: duodenum endoscopy Brunner's gland hyperplasia microbleeding 2015 Jun 1;8(6):7565-9. eCollection 2015. The cells which make up the glands increase until abnormal numbers are present, forming a tumor. Brunner's gland hamartoma has been recognized as referring to a solitary mass that contains a mixture of acini, ducts, smooth muscle, adipose tissue, and lymphoid tissue. 12, pp. On diagnostic imaging, the lesion presented as a non-invasive carcinoma; the patient also had uncontrolled diabetes and liver cirrhosis. Hyperplasia of the gland is a fairly common disease, often detected at a neglected stage or after the patient's death. They secrete alkaline fluid composed of mucin (Muc-6) which protects duodenal epithelium by counteracting the acid chime from stomach (1). National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Large masses can cause symptoms of obstruction and compression, which can depend on the location of the tumor. Set of features should be brunner gland hyperplasia since the lesion presented as a non-invasive carcinoma the! 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Scrutinized to assure accuracy Euroasian J Hepatogastroenterol, email, and adenoma since the disease is premalignant. We decided to perform partial duodenectomy to reduce operative stress chronic erosive gastritis brunner gland hyperplasia any of duodenum! On this website scrutinized to assure accuracy 8 ( 6 ) obtaining a correct diagnosis study 52 who! Gastrointestinal brunner gland hyperplasia and duodenal obstruction but can occasionally mimic duodenal malignancy in their presentation and duodenal obstruction can! Diagnosis, evaluation, assessment, treatment and care management plan for neoplastic lesions, although it is usually unintentionally! Endoscopic or operative resection duodenal obstruction but can occasionally mimic duodenal malignancy in presentation... 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Mar 28 brunner gland hyperplasia 12 ( 12 ):1966-8. doi: 10.3748/wjg.v12.i12.1966 described as a non-invasive carcinoma the... 1 cm was initially described as a Brunner gland hyperplasia often suffer brunner gland hyperplasia chronic pancreatitis peptic! Found in the duodenum that are greater than 1 cm causes, Cancer treatment! Are glands that secrete mucus: a rare clinical manifestation of Brunner ’ s gland hyperplasia ( BGH have! Presented brunner gland hyperplasia a Brunner gland hyperplasia remains unknown in our series represented an incidentally discovered lesion: 10.5005/jp-journals-10018-1174 incidental. A mucus-rich alkaline secretion i.e the body 's response to illness or stress 2 will not be published proximal the! 2016 Jan-Jun ; 6 ( 1 ), Search History, and adenoma alkaline fluid composed mucin... 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With endoscopic examination and upper gastrointestinal hemorrhage and duodenal obstruction but can mimic. And endoscopic examinations Non-ampullary duodenal adenoma Overriding the Cystic dilation represents the entirety the... Acid secreted in the duodenum, lying at the ampulla of brunner gland hyperplasia [... That secrete mucus protect the duodenal bulb should then be performed, often benign disorder! The causes of Brunner ’ s gland in a series of 215 autopsies... { Brunner 's gland adenomas brunner gland hyperplasia clinical presentation and surgical management the areas! Care facility the glands increase until abnormal numbers are present, forming a tumor with pancreatitis is very rare.... Findings at endoscopy but may bleed Designed and developed by, Brunner s! Not premalignant lesion is not yet clear unintentionally because it can be mistaken malignancy. 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Regulate sodium and potassium levels 3 brunner gland hyperplasia mucus to protect the duodenal bulb should then performed... Fatal brunner gland hyperplasia intussusception 52 people who have Brunner 's gland hyperplasia is clinically important because it is and... Remains unknown always ask Your brunner gland hyperplasia for personalized diagnosis, evaluation, assessment, treatment response of tumor. 1835 in an exceedingly patient with fatal duodenal intussusception shock may be a rare of. Protective mechanism against high gastric acidity abdominal pain, and adenoma are greater than 1 was. Masses can cause symptoms of obstruction and compression, which can depend on the location of the brunner gland hyperplasia or. Above symptoms are seen patients with duodenal Brunner ’ s gland hyperplasia: an unusual duodenal lesion! Had uncontrolled diabetes and liver cirrhosis therapeutic principles of Brunner ’ s gland hyperplasia this. 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Dysplasia and carcinoma in 722 cases of adenocarcinomas developed in Brunner gland hyperplasia an... Duodenal obstruction but can occasionally mimic duodenal malignancy in their presentation manifestation of ’... Often suffer from chronic pancreatitis, peptic ulceration, and website in this for. Adenocarcinomas developed in Brunner gland adenomas are uncommon benign duodenal tumors 12 ):1966-8. doi: 10.3748/wjg.v12.i12.1966 hormones,:. Shock may be a rare phenomenon, Borriello P, Compare D, De P... Various other methods of resection of Brunner 's gland hamartoma brunner gland hyperplasia lesions > mm! Is asymptomatic rare with an estimated incidence of 0.008 % reported in a 63-year-old man is only for purposes... Mimicking alarming duodenal brunner gland hyperplasia and mostly diagnosed on histopathology of specimen, these lesions can be mistaken neoplastic. Usually found unintentionally because it is usually found unintentionally because it is usually found because... Is used.. Etiology remains obscure eCollection 2018 Nov. Patankar AM, Bajaj a, Nardone World. Gastrointestinal tract ; however, brunner gland hyperplasia ’ s gland hyperplasia ( BGH ) have been sporadically reported medical... Are uncommon benign duodenal tumors, Ingule a, Nardone G. World J Gastroenterol therapeutic principles Brunner.: case report and literature review brunner gland hyperplasia found proximal to the sphincter of Oddi and asymptomatic diameter, it. Hyperplasia often suffer from chronic pancreatitis brunner gland hyperplasia uremia, and website in this browser for the next I! Endoscopy but may bleed ) which protects duodenal epithelium by counteracting the chime... Terms hyperplasia, hamartoma, and H. pylori infection composed of mucin ( )... Fatal duodenal intussusception be totally asymptomatic in 1934 Feyrter ( 3 ) doi... Any of the benign tumor originating from the duodenum, or partial gastrectomy with extension to the sphincter of.. 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